Oral Surgical Treatment and Management Update for Prosthetic Heart Valves Patients

The individuals with implanted prosthetic heart valves (PHV) belong in the group of patients with high risk from several aspects. The aim of this work was to show the specific stomatological approach and treatment of patients with PHV. The research included 40 individuals. The preparation included: laboratory blood examination (number of blood platelets, haematocrit, prothrombin time, INR), and antibiotic prophylaxis (according to the protocol of the American Heart Association – AHA).
Detail anamnesis, inspection and X ray examination have been provided on the entire examined person. Fourty oral surgery interventions have been made. The oral anticoagulants have been interrupted before the interventions and low molecular weight heparin (LMWH) has been included, before and after the interventions. Definitive local homeostasis has been accomplished with the use of 5% tranexamic acid as mouthwash solution.
The patients have been followed through from aspect of possible development of local and general complications after the intervention and in one month period concerning the general health condition. Complications such as prolonged bleeding, development of infective endocarditis and thromboembolism episode have not been established.
Selective approach and preparation as well as interdisciplinary cooperation with the cardiologists are the base for safe and quality oral surgery treatment of prosthetic heart valves patients.
Key words: tooth extraction, oral surgery, prosthetic heart valves, oral anticoagulants, tranexamic acid.